Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
Ultrasound Obstet Gynecol. 2010 Apr;35(4):468-73. doi: 10.1002/uog.7547.
To estimate the effectiveness of cerclage according to degree of cervical length (CL) shortening.
A meta-analysis was carried out of trials of women with singleton gestations and second-trimester transvaginal sonographic CL < 25 mm randomized to cerclage or no cerclage. The degree of CL shortening was correlated to the efficacy of cerclage in preventing preterm birth.
There was a significant reduction in preterm birth < 35 weeks in the cerclage compared with no cerclage groups in 208 singleton gestations with both a previous preterm birth and CL < 25 mm (relative risk, 0.61; 95% CI, 0.40-0.92). In these women, preterm birth < 37 weeks was significantly reduced with cerclage for CL < or = 5.9 mm, < or = 15.9 mm, 16-24.9 mm and < 25 mm. None of the analyses for 344 women without a previous preterm birth was significant.
Cerclage, when performed in women with a singleton gestation, previous preterm birth and cervical length < 25 mm, seems to have a similar effect regardless of the degree of cervical shortening, including CL 16-24 mm, as well as CL < or = 5.9 mm.
根据宫颈长度（CL）缩短程度评估宫颈环扎术的效果。
对患有单胎妊娠和经阴道超声 CL < 25 mm 的女性进行了一项荟萃分析，这些女性被随机分配至行宫颈环扎术或不行宫颈环扎术。CL 缩短程度与预防早产的宫颈环扎术效果相关。
在 208 例既往有早产且 CL < 25 mm 的单胎妊娠中，与不行宫颈环扎术组相比，行宫颈环扎术组可显著降低< 35 孕周的早产（相对风险，0.61；95%置信区间，0.40-0.92）。对于 CL < or = 5.9 mm、< or = 15.9 mm、16-24.9 mm 和 < 25 mm 的这些女性，行宫颈环扎术可显著降低< 37 孕周的早产。在 344 例无既往早产的女性中，无任何分析具有统计学意义。
对于有单胎妊娠、既往早产和 CL < 25 mm 的女性，行宫颈环扎术似乎具有相似的效果，而与宫颈缩短的程度无关，包括 CL 16-24 mm 和 CL < or = 5.9 mm。
